TABLE 7.

Bradford-Hill criteria and application by the Institute of Medicine¹

Bradford-Hill criteria (78)	Diet and health (12) and DRI reports (14, 23, 24, 29, 36–38)
Strength: effect sizes (not statistical significance)	Yes
Consistency: consistency across study types, locations, populations, study times, and other factors	Yes
Specificity: Is there likely one cause for the effect? Is the association specific to a particular population, context, or outcome and not observed in other populations, contexts, or outcomes?	Yes
Temporality: cause before effect with appropriate delay	Yes
Biological gradient: dose-response relation (could be curvilinear with a dose-response relation in part of the curve)	Yes
Biological plausibility: Is the nutrient of interest a biologically plausible cause of the beneficial effect?	Yes
Coherence: Does cause-and-effect interpretation of data seriously conflict with generally known facts and laboratory evidence?	No
Analogy: Is it possible to judge by analogy?	No
Experiment: Is there experimental evidence from human and/or animal and in vitro studies that is consistent with the associational findings?	No, with the exception of the 2011 DRI report (14)

¹DRI, Dietary Reference Intake.